Aims and objectives
Ulnar impingement syndromeis caused by a shortened distal ulna that impingeson the distal radius proximal to the sigmoid notch.Most often,
a markedly shortened distal ulnaresults from any of the surgical procedures thatinvolve resection of the distal ulna,
howeverulnar impingement may bepresent in de novo cases of negative ulnar variance for premature fusion of the distal ulna.
To verify the frequency of idiopathic Ulnar Impingement Syndrome (iUIS) in patients with neither trauma nor wrist/ulnar surgical history in the general population and to characterize radiologically the association...
Methods and materials
This single center,
declaration of Helsinki-compliant study,
was approved by the institutional board and the informed consent was waived.
Plain radiographs of wrist (X-rays) executed in EAD between January 2015 and July 2017 was retrospectively reviewed for the presence of UIS signs (mild to severe) then the anatomy of the carpal bones was assessed: ulnar tilt,
scapho-lunate angle,
lunate fossa angle,
palmar carpal displacement,
proximal Gilula's line,
chondrocalcinosis.
X-rays of patients <18 years old,
with previous wrist/ulnar surgery,
trauma or inadequate images were excluded.
Results
We examined 529 X-rays and we excluded 136 of them because of exclusion criteria.
The overall frequency of iUIS was 2.5% (10/393).
In patients with iUIS the mean±SD age was 53.7±23.8 years (18-93),
ulnar tilt 21.8±5.9° (12.3-30.0),
scapho-lunate angle 52.5±8.3° (42.2-64.8),
lunate fossa angle 22.6±7.1° (13.8-38.0) and palmar carpal displacement 16.4±8.5 mm (7.4-28.6).
Proximal Gilula's line was interrupted in 3 (30%) patients and 3 (30%) showed chondrocalcinosis.
Conclusion
iUIS is a radiological finding in general population,
it can be described in patients of any age and it's frequently associated with signs of chondrocalcinosis,
crystaldeposition arthropathy and carpal instability,
included perilunate dislocation but not scapho-lunate dissociation.
This extension of this study will provide a better definition of the relation between the ulnar and the carpal findings.
Personal information
Ivan Gigantelli,
MD
Institute of Radiology,
Departmentof Medicine,University of Padua
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